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Extracorporeal Membrane Oxygenation: Experience In Acute Graft Failure After Heart Transplantation
ConclusionTemporary ECMO support for postoperative output failure is an acceptable option as a last resort for otherwise doomed patients with fatal graft failure after HTx. The small fraction of patients surviving, appear to have a decent long‐term prognosis.This article is protected by copyright. All rights reserved.
Source: Clinical Transplantation - April 1, 2014 Category: Transplant Surgery Authors: Sven Lehmann, Madlen Uhlemann, Christian D. Etz, Jens Garbade, Thomas Schroeder, Michael Borger, Martin Misfeld, Hartmuth B Bittner, Friedrich Wilhelm Mohr Tags: Original Article Source Type: research

Post-approval study of a highly pulsed, low-shear-rate, continuous-flow, left ventricular assist device, EVAHEART: A Japanese multicenter study using J-MACS
Conclusions: The EVAHEART device provides safe, reliable and long-term circulatory support with improved survival in commercial settings of BTT in Japan, where the transplant waiting period is much longer. Incidences of GI bleeding, hemolysis, right ventricular failure, device thrombosis and mechanical failure were extremely rare in patients on EVAHEART devices.
Source: The Journal of Heart and Lung Transplantation - March 6, 2014 Category: Transplant Surgery Authors: Satoshi Saito, Kenji Yamazaki, Tomohiro Nishinaka, Yuki Ichihara, Minoru Ono, Syunei Kyo, Takashi Nishimura, Takeshi Nakatani, Koichi Toda, Yoshiki Sawa, Ryuji Tominaga, Tadahisa Tanoue, Yoshikatsu Saiki, Yoshiro Matsui, Takahiro Takemura, Hiroshi Niinami Tags: Featured Articles Source Type: research

First Implantation in Man of a New Magnetically Levitated Left Ventricular Assist Device (HeartMate III)
Outcomes of heart failure patients supported by a continuous flow left ventricular assist device (LVAD) have steadily improved over the past decade due in large part to better patient selection and management 1,2. Nevertheless, adverse events such as bleeding, infection, stroke and thrombus persist and limit the overall effectiveness of this therapy. Bleeding is the most common serious adverse event that results from the extensive surgery required for implantation and blood component damage due to shear forces in the small blood flow paths of current design axial-flow and centrifugal-flow pumps.
Source: The Journal of Heart and Lung Transplantation - March 7, 2015 Category: Transplant Surgery Authors: Jan D. Schmitto, Jasmin S. Hanke, Sebastian V. Rojas, Murat Avsar, Axel Haverich Source Type: research

Temporal Distribution of Hematologic Complications During Berlin EXCOR Support
The Berlin Heart EXCOR trial demonstrated a high incidence of bleeding complications and stroke. Little is known, however, with regards to the timing of these events. The purpose of this study is to describe a single center experience with the Berlin EXCOR VAD, with a particular focus on the temporal distribution of these mutually related complications.
Source: The Journal of Heart and Lung Transplantation - April 1, 2015 Category: Transplant Surgery Authors: S. Burki, D.H. Mahoney, A. Jeewa, W. Zhang, E. McKenzie, D.L. Morales, C.M. Mery, J.S. Heinle, C.D. Fraser, I. Adachi Source Type: research

Temporal Differences in Adverse Event Rates in Patients Bridged With the HeartWare Left Ventricular Assist Device
Left ventricular assist devices (LVAD) have significantly improved survival and quality of life in patients with advanced heart failure. However, these devices are associated with significant adverse events (AEs), particularly bleeding, infection, stroke and right heart failure. We sought to evaluate temporal differences in AE rates in patients bridged to transplantation.
Source: The Journal of Heart and Lung Transplantation - April 1, 2015 Category: Transplant Surgery Authors: S. Maltais, K.D. Aaronson, J.J. Teuteberg, M.S. Slaughter, S.S. Najjar, V. Jeevanandam, D.T. Pham, E.C. McGee, K. Najarian, R.L. Kormos Source Type: research

Lung Transplantation and the Routine Use of Cardiopulmonary Bypass and Median Sternotomy: Experience at the Ochsner Multi-Organ Transplant Institute.
CONCLUSION: Patients' early outcomes appear to have improved with the use of CPB and median sternotomy; however, 3-year survival is similar to the non-CPB group. Technical benefits of CPB with median sternotomy include decreased warm ischemia time during graft implantation, controlled hemodynamics and reperfusion, avoidance of single-lung ventilation of a freshly implanted graft, and the option to open the left atrium for implantation of a venous cuff without using a clamp. The surgical exposure facilitated by CPB with median sternotomy for lung transplantation appears to be a safe and feasible approach for lung transplant...
Source: Ochsner Journal - March 25, 2017 Category: Journals (General) Tags: Ochsner J Source Type: research

Increased Frequency of Bleeding Complications in Females Following LVAD Implant
While females are at increased risk for stroke after left ventricular assist device (LVAD), the impact of sex on mortality has been met with conflicting results and there is few data on sex specific bleeding rates. Bleeding is a major source of morbidity and mortality in the LVAD population. The aim of this analysis is to define the incidence and clinical impact of bleeding stratified by sex.
Source: The Journal of Heart and Lung Transplantation - March 25, 2017 Category: Transplant Surgery Authors: Z. Yavar, J. Cowger, S. Moainie, C. Salerno, A.K. Ravichandran Source Type: research

Outcomes of Asian-Americans Undergoing Left Ventricular Assist Device Implantations as a Bridge to Transplant or Destination Therapy: An INTERMACS Analysis
Previous studies have demonstrated significant differences between Asians and Caucasian white populations in their propensity for stroke, coronary artery disease, heart failure, inflammation, bleeding and thrombosis. Therefore, we hypothesized that Asian Americans with end stage heart failure undergoing treatment with durable left ventricular assist devices (LVAD) exhibit a different morbidity and mortality risk profile when compared to non-Asian and white Americans populations.
Source: The Journal of Heart and Lung Transplantation - March 25, 2017 Category: Transplant Surgery Authors: J.R. Wever Pinzon, W. Wang, N. Hu, R. Larsen, T. Yu, L. Yin, I. Taleb, A. Koliopoulou, S. Mckellar, J. Stehlik, J. Fang, A. Kfoury, C. Selzman, S. Drakos Source Type: research

Managing Anticoagulation in LVAD Patients: The Harefield Experience
Anticoagulation management in patients with Left Ventricular Assist devices (LVAD) continues to be a challenge. Patients and their clinicians are faced with the daily challenge of needing adequate anticoagulation versus the bleeding risks that are associated with anticoagulation.Warfarin is the recommended oral anticoagulant for all currently available LVAD devices.Warfarin is known to be a difficult medication to manage due to its narrow therapeutic window, and its many interactions .Dlott et al (2014) describe in Circulation the overall time in therapeutic range for patients on warfarin as 53.7%, Time in therapeutic rang...
Source: The Journal of Heart and Lung Transplantation - March 25, 2017 Category: Transplant Surgery Authors: R. Hards, G. Edwards, C. Kavanagh, M. Hedger, A.R. Simon Source Type: research

Intraoperative extracorporeal membrane oxygenation versus cardiopulmonary bypass for lung transplantation: A meta-analysis
Conclusion: ECMO support for LuTx showed better clinical outcomes compared to CPB.
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Magouliotis, D., Svokos, A., Svokos, K., Olland, A., Massard, G., Tasiopoulou, V., Zacharoulis, D. Tags: Transplantation Source Type: research

Anticoagulation with VADs and ECMO: walking the tightrope.
Authors: Raffini L Abstract The evolution of devices for mechanical circulatory support (MCS), including ventricular assist devices (VADs) for patients with heart failure and extracorporeal membrane oxygenation (ECMO) for patients with acute cardiac or respiratory failure, has improved survival for subsets of critically ill children and adults. The devices are intricate and complex, allowing blood to bypass the heart or lungs (or both). As blood flows through these artificial devices, normal hemostasis is disrupted, coagulation is promoted, and in the absence of anticoagulation, a thrombus may form in the device, r...
Source: Hematology ASH Education Program - December 10, 2017 Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research

Flow Performance of the CorWave LVAD Membrane Wave Pump
Implantable long-term blood pumps currently available or in development employ high speed rotary impellers. Use of these devices is currently limited due to relatively high rates of stroke, bleeding complications and infection. A new blood pump technology is under development inspired by the swimming motion of a fish. High frequency, low amplitude linear actuation creates a wave motion on a polymer membrane, gently pushing the blood through the pump. This approach offers a less damaging method for pumping blood, provides full physiologic pulsatility and can operate efficiently over a wide range of operating conditions.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: C.N. Botterbusch, P. Monticone, L. Polverelli Source Type: research

Bayesian Model for Predicting 90 Day Event Free Survival in LVAD Patients
Potential adverse outcomes are often quoted individually to patients (e.g. 4% risk of stroke or bleeding) pre LVAD implantation. However, technical medical aspects may impact their grasp of perceived ‘overall’ risk and hence their ability to match expectations and post-op consequences. We assessed survival free from any major adverse event (MAE) and predict their occurrence within the first 90 days after LVAD implant.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: M. Kanwar, L. Lohmueller, R. Kormos, C. Mcilvennan, S. Bailey, S. Murali, J. Antaki Source Type: research

First-in-Man Use of the MVAD Axial-Flow Pump: Long Term Outcome
The use of durable continuous-flow mechanical assist devices provides selected heart failure patients with both symptomatic and functional benefits; however, they are not without potential complications. Infection, thrombosis, stroke and GI bleeding are amongst the most commonly reported problems of left ventricular assist device (LVAD) therapy.1 –3 In addition, LVAD peripherals can be bulky and heavy for the patient to carry, causing joint stress, discomfort and reduced quality of life. Device miniaturization is one design trend that has enabled device implantation in patients with a broader range of body sizes, and whe...
Source: The Journal of Heart and Lung Transplantation - April 24, 2018 Category: Transplant Surgery Authors: Marian Urban, Anfrew Woods, Nicola Robinson-Smith, Guy MacGowan, Chandrika Roysam, Stephan Schueler Source Type: research

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